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Peripheral Steroid Levels in a Patient With Vitalizing Adrenal Adenoma

From the Division of Endocrinology. Department of Pathology and Medicine. Baylor University Medical Center. Dallas. Texas and the Division of Reproductive Biology. Department of Obstetrics and Gynecology, UCLA School of Medicine, Harbor General Hospital Campus. Torrance. California

Abstract

The peripheral levels of pregnenolone (³-p), 17-hydroxypregnenolone (17-³-P), progesterone (P), 17-hydroxyprogestcrone (17-P), testosterone (T), 5 -dihydrotestosterone (DHT), androstencdione (A), dehydroepiandrostcrone (DHEA), its sulfalc (DHEA-S), estronc (E₂), estradiol-17ß (E₂), and cortisol (F) were measured prior to and 11/2 and 9 months after removal of a right adrenal "compact cell" adenoma in an amenorrheic patient with a virilizing adrenal adenoma, under the following conditions: 1) control for 2 days, 2) dexamethasonc, 0.5 mg, every 6 hours for 2 days, and 3) dexamclhasonc, 2 mg, every 6 hours for 2 days. Except for E₂, E₂, and F, the control levels of ail steroids measured were elevated, markedly so for ³-P, 17-³-P, DHEA, A, and DHEA-S. Dexamethasonc treatment had no detectable effect on the steroid levels. Following removal of the adrenal adenoma, the levels of all steroids returned to normal. The patient became cumenorrheic, with marked improvement of her hirsutism and virilization.